Multiple purpose stopcock arrangement for suctioning, injection, oxygen cessory equipment

ABSTRACT

A bronchoscope is provided with means permitting the introduction or removal of fluids into or from a patient&#39;&#39;s lungs while at the same time performing a biopsy or obtaining specimens by means of a brush or otherwise. Moreover, the operations being performed may be continually observed by one or more persons who can manipulate the equipment readily and without interrupting the procedure to carry out the various different operative steps.

United States Patent, 1191 Shinnick, D.O.

MULTIPLE PURPOSE STOPCOCK ARRANGEMENT FOR SUCTIONING, INJECTION, OXYGENCESSORY EQUIPMENT James P. Shinnick, D.O., Pickwick Village Apts., J-l5,Maple Shade, NJ. 08050 Filed: Jan. 31, 1973 Appl. No.: 328,350

Inventor:

US. Cl. 128/2 B, 128/4 Int. Cl .Q A61b 1/26 Field of Search 128/2 B, 2R, 4, 6

References Cited UNlTED STATES PATENTS 10 1954 Wallace 128/6 10/1960MacLean 128/2 B Aug. 20, 1974 2/1972 Takahashi et a1 128/6 FOREIGNPATENTS OR APPLICATIONS 1,211,360 2/1966 Germany 128/6 PrimaryExaminerLucie H. Laudenslager Attorney, Agent, or FirmSperry and Zoda [57] ABSTRACT A bronchoscope is provided with means permitting theintroduction or removal of fluids into or from a patients lungs while atthe same time performing a biopsy or obtaining specimens by means of abrush or otherwise. Moreover, the operations being performed may becontinually observed by one or more persons who can manipulate theequipment readily and without interrupting the procedure to carry outthe various different operative steps.

10 Claims, 5 Drawing Figures PAIENTEDmczomm SHEET 1 or 2 MULTIPLEPURPOSE STOPCOCK ARRANGEMENT FOR SUCTIONING, INJECTION,-

OXYGEN CESSORY EQUIPMENT FIELD OF INVENTION Bronchoscopes known asfiberoptic bronchoscopes, have been developed which are characterized bytheir increased flexibility and range of visualization while affordinggreater comfort or tolerance to the patient. However, in performing manyexaminations and treat ments of a patient, it is desirable to performtwo or more operations simultaneously, as when it becomes necessary toaspirate or inject fluids through the bronchoscope while leaving biopsyforceps or other instruments in place.

Such procedures have not been possible heretofore due to the necessityof removing the forceps, suction or aspirating equipment, or the like,in order to carry out another operative step of the examination orprocedure.

In accordance with the present invention, means are provided in thenature of valves or control means which can be readily manipulated bythe operator during examinations to allow the introduction or removal offluids or instruments or both without withdrawing other equipment fromthe bronchoscope. In particular, the present invention may be in theform of an accessory device adapted for attachment to fiberopticbronchoscopes to increase the utility and capabilities thereof.

THE DRAWINGS FIG. 1 is a diagrammatic illustration of a fiberopticbronchoscope having a typical embodiment of the present inventionapplied thereto as an accessory.

FIG. 2 is an enlarged sectional view of the elements of the accessoryshown in FIG. 1 in one position thereof; and FIGS. 3, 4, and 5 are viewssimilar to FIG. 2 illustrating alternative positions of the elements ofthe device.

PREFERRED EMBODIMENT In that form of the invention chosen for purposesof illustration in the drawings, the bronchoscope is preferably of thetype known as a flberoptic bronchoscope and is provided with a body 2having an eyepiece 4 on one end thereof and a tube 6 connected to theopposite end thereof for insertion into a patients lung'. A light tube'8 is also connected at one end to the body 2 and has an electricalconnector 10 on the opposite end thereof for providing illumination incarrying out an examination'or performing an operation. If desired, asecondary eyepiece 12 may be connected to the eyepiece 4 to permit anassistant or student to observe the operations'being performed by thedoctor using the bronchoscope.

'In accordance with the present invention, a unit 14 is connected to thebody 2 of the bronchoscope and has a passage 16 therethrough for theinsertion and removal of an instrument 18 such as biopsy forceps,curettes, brushes, or'the like, which may be passed into and out of thetube 6 for obtaining cytological specimens or'performing operative orother procedures. The

outer end of the unit 14 and passage 16 are normally closedby a membraneor closure element 20 (FIGA) which is movable to permit the insertionand removal of instruments 18, whereas the opposite or inner end of theunit 14 is provided with threads or other attaching means 22 by whichthe unit 14 may be secured tov the body 2 of the bronchoscope.

The passage 16 between the closure element 20 and the outlet end 23thereof is enlarged in cross section so as to provide a space 25 aboutthe instrument 18 for the flow of fluids into and out of the tube 6 ofthe bronchoscope while the instrument remains in place within thepassage 16.

The unit 14 is provided at about the mid-point thereof with a lateralextension 24 for connection with a tube or conduit 26 by which fluidsmay be passed into or out of the passage 16 of the unit through anopening 28 in the enlarged portion of the passage. A member 30 in thegeneral form of a stop cock is located in the enlarged portion of thepassage 16, adjacent the opening 28. The member 30 has three portstherein arranged with the ports 32 and 34 on opposite sides of the.member 30 and of such size as to permit the instrument represented at18 to be passed freely through the ports. The third port 36 ispositioned at right angles to the ports 32 and 34 and designed tocooperate with the opening 28 in passage 16 of the unit 14 to permit theflow of fluids through the unit to and from the conduit 26 and the tube6 of the bronchoscope. A handle 38 connected to the member 30 projectsoutward at the end of the unit 14 to permit the member 30 to be moved tothe position of FIG.2 wherein the ports 32 and 34 are located so as toallow the passage of an instrument 18 through the unit. At the sametime, the port 36 is brought into registry with the opening 28 in theunit 14 to provide communication of the conduit 26 with the tube of thebronchoscope. However, when no instrument is being used, the member 30may be moved to the position of FIG. .5 to provide only for fluid flowthrough the unit 14 and conduit 26 under .control of a valve 40.

The conduit 26 may be of any suitable or convenient length, say about 20centimeters, and is connected to control means such as the valve 40. Thevalve is .designed to control the flow of fluids to and from the unit 14and tube 6 to permit oxygen, fluid medication, or the like, to beadministered to the patient and to permit body fluids, mucous, blood, orthe like, .to be withdrawn from the patients lungs.

The valve 40 is preferably constructed to be operated manually by onehand so that the doctor or assistant will have the other hand free.tohandle 'instrumentsor the like. For this purpose the valve ispreferably ,provided with a tubularbody 42 within which aplunger 44 isaxially movable. A spring 46 located in the base of the tubular body42'bears against the lower end of the plunger 44 to urge it outward inthe valve body, whereas the plunger may be depressed against the .ac-

' tion of the spring 46 by pressure appliedtotheplunger nication with acylindrical connector 58 secured to the body 42 of the valve to whichthe tubular conduit 26 is attached. Further, the plunger 44 is providedwith a through passage 60 by which the conduit 26 may be brought intocommunication with a connector 62 carried by the body 42 of the valvefor the application of suction to remove fluids from the patients lungthrough tube 6, unit 14 and conduit 26 under control of the valve 40.

The construction thus provided is capable of varied uses permitting theapplication or removal of fluids to or from a patients lung at all timeswhile the tube 6 of the bronchoscope is in place and further, renders itpossible to apply or remove such fluids while employing instruments orcarrying out and observing the operations being performed. Moreover, itis not necessary to remove the instruments from the unit andbronchoscope in order to introduce or remove fluids to or from the areabeing observed or upon which operations are being performed.

Accordingly, in using the equipment as shown in FIG. 2, the member 30 ofunit 14 is moved by handle 38 to a position in which the ports 32 and 34are aligned with the passage 16 whereby the instrument 18 may be passedthrough the closure element 20 at the upper end of the unit and into thetube 6 of the bronchoscope for performing the desired operations. At thesame time, the port 36 of the member 30 is brought into registry withthe opening 28 in the unit 14 for communication with the conduit 26.Thereafter, if it is desired to introduce oxygen or other fluids intothe patients lung, the plunger 44 of valve 40 may be depressed againstthe action of spring 46 to bring the lateral opening 56 in cavity 50 ofthe plunger into communication with the conduit 26, as shown in FIG. 3.Fluid may then flow from the cavity 50 through conduit 26 to the passage16 in unit 14, and, thence through the space 25 about the instrument l8and into the tube 6 of the bronchoscope, as indicated by the arrows 64of FIG. 2.

In the alternative, if fluid is to be removed from the patients lungthrough tube 6 of the bronchoscope, the plunger 44 of the valve 40 maybe moved to a position of FIG. 4 in which the plunger providescommunication between conduit 26 and connector 62 for the application ofsuction to the unit 16 and tube 6 of the bronchoscope. Fluid will thenflow through the tube and unit past the instrument 18, as indicated bythe arrow 66 of FIG. 4, to conduit 26 and valve 40 for discharge throughconnector 62.

The flow of fluid into or out of the patients lung can thus be effectedwithout removal of the instrument l8 and without obstruction to the viewof the operator using the bronchoscope.

Further, in using the equipment of the present invention when noinstruments are being employed, the handle 38 of the unit 14 may bemoved to rotate the member 30 within the unit to position shown in FIG.5, wherein the port 36 in member 30 communicates with the tube 6 of thebranchoscope and port 32 communicates with the conduit 26 controlled bythe valve 40. The operator may then depress the plunger 44 of the valveagainst the action of spring 46 to either the position as shown in FIG.3, wherein the laterally directed opening 56 will be brought intocommunication with the conduit 26 or to the position of FIG. 4, whereinthe through passage 60 therein serves to bring the conduit 26 intocommunication with connector 62 for the application of suction tobronchoscope tube 6 to remove fluids from the patients lung.

The movement of the plunger 44 of valve can be effected by a finger ofone hand grasping the valve and if desired, the amount of suction orpressure applied in supplying or removing fluids to or from the conduit26 and tube 6 may be varied by th operator by depressing the plunger ina controlled manner to bring the opening or through passage in the valveinto limited or full registry with the connector 58 to which the conduit26 is attached.

In the alternative and if more convenient, oxygen or the like or suctionmay be applied directly to the unit 14 through the membrane or movableclosure element 20 at the outer end of the unit 14. In that event, thevalve 40 need not be employed and the plunger 44 will remain in itsuppermost position, as shown in full lines in FIG. 2.

While one preferred embodiment of the invention and methods of using theequipment have been shown and described above, it will be apparent thatnumerous changes may be made in the form, construction and arrangementof the various elements of the combination. In view thereof, it shouldbe understood that the particular embodiment of the inventionillustrated in the drawings is intended to be illustrative only and isnot intended to limit the scope of the following claims.

I claim:

1. In combination with a bronchoscope embodying a flexible tube forinsertion into a patients lung; a detachable unit adapted to beconnected to said bronchoscope and formed with a passage therethrough topermit insertion and removal of instruments through said unit and intosaid tube; a conduit connected to said unit and control means connectedto said conduit through which fluids may be passed to and from saidconduit, unit, and tube.

2. A bronchoscope as defined in claim 1, wherein said control means ismovable to alternative positions to permit either the introduction orthe removal of fluids through said tube.

3. A bronchoscope as defined in claim 1, wherein said passage has anopening therein through which fluids may be passed to or from saidpassage, and valve means for selectively opening and closing saidpassage and opening.

4. A bronchoscope as defined in claim 1, wherein said control meansincludes a spring pressed valve manually operable to selectively permitflow of fluid in opposite directions therethrough.

5. A bronchoscope as defined in claim 1, wherein said passage has aclosure adjacent one end thereof movable to permit the insertion andremoval of an instrument through said passage, the opposite end of saidpassage having an internal cross section sufficient to permit the flowof fluids into and out of said passage past an instrument extendingthrough said passage, and an opening communicating with said passagebetween said ends thereof through which fluids may flow into and out ofsaid tube and passage.

6. A bronchoscope as defined in claim 5, wherein said passage has anenlarged portion between the opposite ends thereof and a member islocated in said enlarged portion movable into and out of a position topermit the movement of an instrument through said passage.

9. The combination as defined in claim 8, wherein said conduit has valvemeans therein movable to alternative positions to permit the flow offluid either into or out of said passage and tube.

10. The combination as defined in claim 8, wherein said passage hasmeans therein for blocking said passage to prevent insertion of aninstrument into said tube while permitting the flow of fluid into or outof said tube and conduit.

1. In combination with a bronchoscope embodying a flexible tube forinsertion into a patient''s lung; a detachable unit adapted to beconnected to said bronchoscope and formed with a passage therethrough topermit insertion and removal of instruments through said unit and intosaid tube; a conduit connected to said unit and control means connectedto said conduit through which fluids may be passed to and from saidconduit, unit, and tube.
 2. A bronchoscope as defined in claim 1,wherein said control means is movable to alternative positions to permiteither the introduction or the removal of fluids through said tube.
 3. Abronchoscope as defined in claim 1, wherein said passage has an openingtherein through which fluids may be passed to or from said passage, andvalve means for selectively opening and closing said passage andopening.
 4. A bronchoscope as defined in claim 1, wherein said controlmeans includes a spring pressed valve manually operable to selectivelypermit flow of fluid in opposite directions therethrough.
 5. Abronchoscope as defined in claim 1, wherein said passage has a closureadjacent one end thereof movable to permit the insertion and removal ofan instrument through said passage, the opposite end of said passagehaving an internal cross section sufficient to permit the flow of fluidsinto and out of said passage past an instrument extending through saidpassage, and an opening communicating with said passage between saidends thereof through which fluids may flow into and out of said tube andpassage.
 6. A bronchoscope as defined in claim 5, wherein said passagehas an enlarged portion between the opposite ends thereof and a memberis located in said enlarged portion movable into and out of a positionto permit the movement of an instrument through said passage.
 7. Abronchoscope as defined in claim 5, wherein said member is movable intoand out of a position to close said opening in said passage.
 8. Incombination with a bronchoscope having a body, a tube connected to saidbody for insertion into a patient''s lung, a unit, adapted to beattached to said body and having a passage therethrough communicatingwith said tube through which instruments may be passed into and out ofsaid tube, and a conduit communicating with said passage through whichfluids may flow into and out of said passage and tube.
 9. Thecombination as defined in claim 8, wherein said conduit has valve meanstherein movable to alternative positions to permit the flow of fluideither into or out of said passage and tube.
 10. The combination asdefined in claim 8, wherein said passage has means therein for blockingsaid passage to prevent insertion of an instrument into said tube whilepermitting the flow of fluid into or out of said tube and conduit.